Stepping up and speaking up

Michael Fahy

Nurse Manager

January 2021

Excellence is our way of doing

business…

We meet on Aboriginal land

Introduction- Overview

• Overview of Hunter New England Local Health District

• Connection with WHY

• Overview of Evidence Based Leadership Framework (EBLF),building an

effective culture HOW and WHAT

• Stepping up and speaking up

• Leadership

• Questions

HUNTER NEW ENGLAND LOCAL HEALTH DISTRICT

Group exercise- WHY?

EXCELLENCE: Evidence Based Leadership Framework

- Strategic Plan

- Operational Plan

- 90 Day Action Plan

- Monthly

Accountability

Meetings

- Performance

Development Review

for ALL Leaders

- District Leadership

Forum

- Management

Development

- Service/Network

specific leadership

development

programs

- Leader Rounding

with Staff

- Traffic Light

Reports

- Leader Rounding

with Patients

- Service Rounding

- Key Words

- Managing Up

- Cultural Respect

- Patient Care

Essentials:

• Hourly Patient

Rounding

• Patient Care

Boards

• HAIDET/ISBAR

• Bedside Clinical

Handover

• Follow Up Phone

Calls

• Safety Huddles

• Patient Safety

Briefing

- Values Charter

- Standards of

Behaviour

- Speaking Up

- Code of Conduct

- Reward &

Recognition

- High-Solid-Low

Performance

Conversations

- Rerecuit new staff

(30 & 90 Day

Conversations)

- Skills Labs

- Patient Experience

Tracker System

(PETS)

- Practice

Development e.g.

Essential of Care

- Between the Flags

- Communicating for

Safety

- Cultural Redesign

- Clinical Redesign

- Policies &

Procedures

- Automation

- Technology

- Education

- Research &

Innovation

Culture

Put simply, culture is ‘how things are done

around here’ (Drennan, 1992, p9).

Building a Respectful and Effective Culture

NSW CORE Values

• Collaboration, Openness, Respect, Empowerment

Code of Conduct

HNE Values Charter

Standards of Behaviour/Speaking Up

Why have Standards of Behaviour ?

Behaviours are determined by a group of people as observable

& teachable actions reflecting our CORE values which:

i) they would like to see in their workplace

acceptable = ‘above the line’

ii) they find challenging or of concern

unacceptable = ’below the line’

which help to empower individuals to speak up

Assist new group or team members to quickly adopt to agreed

ways of working

Agreed acceptable behaviours within the Innovation and Support UnitA

bo

ve

th

e lin

e b

eh

avio

urs

Collaboration Openness Respect Empowerment

• Taking responsibility not only for

what you say, but for what others

hear: checking to see that people

have heard and understood what

you are telling them.

• Creating the right environment

for teams to work together.

• To hold regular team meetings to

discuss progress/ share

expertise & information.

• Strive to meet regularly for lunch.

• If you are leaving a car park, let

colleagues know in case they

need to move their car.

• Grant Pauline access to your

diary.

• Record “time in lieu” in calendar

and on share drive.

• Seeing things through to

completion.

• Properly checking with a person

before committing them to doing

something on behalf of the team.

• Freely acknowledging the

source of ideas or good work.

• Speaking plainly about the

truth of a situation when doing

so will help.

• To learn from experience.

• Give it a go! and be open to

feedback and assistance.

• Never judge - assume the best of

others - “allow 5% chance the other

person has a good reason for

doing/saying what they did/said and

investigate that”.

• Speak honestly with positive intention

and care (e.g. use of the two

challenge rule).

• Supporting and respecting each other,

being kind to each other, showing an

interest in each other professionally

and personally.

• Give apologies in advance and make

effective alternative arrangements if

not able to meet a commitment to our

clients.

• Acknowledge traditional owners at

each meeting.

• Take seriously our responsibility to

lead and role model behaviours that

will help in Closing the Gap for

Aboriginal people.

• Acknowledge and appreciate flexibility

that people show when

travelling/participating out of hours:

notice and express concern.

• Consider level of noise in the office

environment e.g. use meeting rooms

whenever possible instead of the shared

office space for large meetings that do

not involve the whole team.

• Getting external

judgement/evaluati

on in what we do.

• Encourage positive

debate and

reflection.

Agreed unacceptable behaviours within the Innovation and Support Unit

Ab

ove

th

e lin

e b

eh

avio

urs

Collaboration Openness Respect Empowerment

• Accepting personal praise for

ideas or work contributed to by

others, without acknowledging

the work of those others.

• Deliberately avoiding a situation

that is difficult, when to resolve it

would be better.

• Making any untrue statement

with the intention to deceive

someone.

• Claiming to possess qualities

or abilities you don't have (or

making claims on behalf of the

team that we can't fulfil).

• Using weasel words

(management talk) rather than

speaking plainly.

• Refraining from speaking about

the truth of a situation when to

do so would help someone (not

speaking up).

• Harsh speech – deliberate offensive

talk of all kinds, including words

intended to make others unhappy or

uncomfortable.

• Saying things about others that you

would not be prepared to discuss with

the person/s directly.

• Failing to clean up after yourself -

don’t expect that others will do it for

you.

• Over critical

feedback that

doesn’t assist

others and the

team to grow and

excel.

Discussion about the unacceptable behaviour should take place ASAP privately after

identification in a respectful manner.

Discussion needs to occur on the shift that the behaviour happens.

What is Speaking Up??

Speaking Up is a way of

communicating professionally

and respectfully. It provides an

environment where staff can

work as a team in a harmonious

environment, where people feel

empowered to discuss issues

where there is a fear of safety

or workplace harmony being

compromised

Speaking Up & Raising Issues

• What a culture permits

Roger Dean

Speaking Up & Raising Issues

• What is the impact if I can’t or won’t Speak Up?

• What can I do to promote a climate that makes

speaking up easier?

• How can we Speak Up respectfully?

Escalating Workplace Disharmony

Issues are magnified

Behaviour is affected

Extreme gestures

Relationships rupturing

Relationships deteriorate

Negative attitudes

Defending positions

Opinions more fixed

Feel resentful and angry

Constant worry or concern

Short sharp exchange

Feeling upset or irritated

Unsatisfactory results

Questions remain

Things don’t feel right

Hard to identify the problem

Uncomfortable

Unsure

Assumptions are made

People perceive the motives for

behaviour in a selective way

Facts are confused

Discomfort

Crisis

Incident

Misunderstandings

Tension

AllTogether Consulting

The 2-challenge rule

1. Question with curiosity

2. Question with concern

3. Bring in a third party or call for assistance

DESK

• Describe the behaviour that has to change

• Evaluate/Explain how the behaviour affects

the performance of the Unit/Health Service

• Show or tell specifically what the employee

needs to do

• Know the consequences

Leadership

• You impact the way people perform in your service by the

• Clarity of your direction

• Ownership and sharing of accountability

• Provision of resources

• Creation of an environment for staff to thrive, not just survive

• Truthfulness of your feedback

• Role modelling of positive behaviours

• Practice with compassion and empathy

• What you permit, you promote… by doing nothing, nothing will change

Questions

References

• PD2015_049 NSW Health Code of Conduct

• HNELHD Workplace Harmony

• Studer, Q (2003) Hardwiring Excellence, Fire Starter Publishing, Florida, USA

• Studer Group (2010) The Nurse Leader Handbook, Fire Starter Publishing, Florida

• Studer, Q (2010) Straight A Leadership, Alignment, Action Accountability, Fire Starter

Publishing, USA

• Excellence